Abstract

Within the MSM population, men who have sex with both men and women (MSMW) are identified as a high-risk group both worldwide and in Europe. In a multi-centred bio-behavioural cross-sectional study, we aimed to assess the relationship(s) between socio-demographic factors, stigma, sexual behavioural patterns, test seeking behaviour and sero-status amongst MSMW. A multi-level analysis was conducted to identify factors associated with being MSMW versus Men who have Sex with Men Only (MSMO). A total of 4901 MSM were enrolled across the 13 study sites. Participants were categorised as MSMW in the 12.64% of the cases. Factors such as educational status, perceived homonegativity, testing facilities knowledge and HIV testing lifetime seem to be relevant factors when characterising the MSMW group. The results highlight the vulnerability of MSMW and the wide spectrum of risky behavioural and psycho-social patterns, particularly in terms of HIV testing, ‘outness’, and perceived stigma.

Notes

Funding

This manuscript is based on data from the Sialon II project, co-funded under the Second Programme of Community Action in the field of Health (2008–2013) (Work Plan 2010) (Grant Agreement Number: 2010 12 11). The sole responsibility lies with the authors of this manuscript and the Commission is not responsible for any use that may be made of the information contained therein.

Author’s Contribution

MMI, LGI, NSH, ITO, LFE, SDI, IVE, DST, SCA, ENA participated in the design of the survey questionnaire and the organisation and implementation of the survey in the survey cities. This analysis was conceived by MMI and LGI. Data were analysed by MMI and LGI. The first manuscript draft was jointly written by MMI and LGI. All authors (MMI, LGI, NSH, JPA, ITO, LFE, SDI, IVE, DST, SCA, MNI, ENA) contributed writing to the following drafts. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Prior to data collection, research protocols were submitted to, and approved by, an appropriate institutional ethical review board in each participating city, as well as by the WHO Research Project Review Panel (RP2) and the WHO Research Ethics Review Committee (ERC) during 2012–2013.

Informed Consent

According to the study protocol procedures, informed consent was obtained from all individual participants included in the study.

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